Care Home: College Green Rest Home

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What the care home does well There is a good system for introducing people to the home and making sure they (and their representatives) have plenty of information about the service before a decision is made about moving in. People are given a information about the home and are invited to visit College Green to look round and meet other people who live there and the staff. No person moves in to College Green without having their needs checked by social workers and staff from the home with the person`s involvement. This helps to make sure their needs can be met at College Green and that their abilities and needs will form the basis of their care plan so care will be given in the way they prefer. People`s care plans are reviewed at least monthly to help ensure that they are always getting the level of support they need. People who live at College Green are offered choices and consulted regularly about the kind of lifestyle they want. Those who sent us comments said the staff are friendly and the manager is kind. People`s special dietary needs are met to ensure they stay healthy. They told us the food is good and their home is comfortable. People`s spiritual needs had been recorded so they could be given the opportunity and any help they need to follow their chosen faith. Arrangements are made for religious ministers to visit College Green in accordance with the wishes of those who live there. There are good procedures so people who live in College Green are able to express their concerns and be listened to. We found good evidence that their rights are protected and they are safeguarded from abuse. People living in College Green receive care and support from a well trained staff team who have gone through a thorough recruitment process to help ensure that only people who are suitable will be employed. There is a low turnover of staff in this home so most of the staff have been employed for a number of years. This provides good continuity of care and will benefit people who live in College Green. We saw that the management of College Green is based on openness and respect. This ensures that the home is run in the best interests of the people who live there. What has improved since the last inspection? During this visit we saw that a number of rooms have recently been decorated and furniture and floor coverings replaced as needed. A new cooker and clothes dryer have been installed since our last visit to improve efficiency. The five yearly electrical certificate was due, and work on the system was in progress during our visit. What the care home could do better: We consider that College Green provides excellent outcomes for the people who live there so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the high standard of care provided to the residents at the time of our inspection is maintained and where possible improved upon. Inspecting for better lives Key inspection report Care homes for older people Name: Address: College Green Rest Home 14 College Road Crosby Liverpool Merseyside L23 0RW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Thomas     Date: 2 4 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: College Green Rest Home 14 College Road Crosby Liverpool Merseyside L23 0RW 01519282760 01519491252 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Margaret Prance,Mr Ian Simon Prance care home 21 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of service users who can be accommodated is: 21 Date of last inspection Brief description of the care home College Green is a care home for twenty one older people who are assessed with dementia. The home is situated in a quiet residential area of Crosby, opposite a park and close to bus routes and local shops and restaurants. College Green is a converted Victorian family house with a front car park and a secluded rear garden. The home provides those in residence with twenty four hour care and accommodation, social activities, home cooked meals and a laundry service. All those living in College Green Care Homes for Older People Page 4 of 25 Over 65 0 21 Brief description of the care home are registered with a doctor of their choice and have access to community health services as they need it. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three stars. This means that people who use this service experience excellent quality outcomes. Some weeks before this visit took place, we (the commission) asked the manager to fill in and return a questionnaire that we call an Annual Quality Assurance Assessment (AQAA). It gives us information about how the home is meeting the needs of the people who use the service and includes future plans for development. We felt this form was filled in honestly and that a lot of time and effort had been given to filling it in. It provided us with good information to help us plan our visit to the home. During the visit we walked around the home and spent time with the people who live there and staff who support them. We saw how choice is promoted when meals are served and how social activities are arranged. We used a system called case tracking. This is a way of inspecting that helps us to look at services from the point of view of Care Homes for Older People Page 6 of 25 some of the people who use them. We track peoples care to see whether the service meets their individual needs. We looked at procedures in place for staff guidance and their training and recruitment records to check that they have been vetted and have the knowledge and skills to support people properly and safely. The charges for this service at the time of the visit were local authority rates for those who have funding from their local council, or 470 pounds per week week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 25 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into College Green receive plenty of information to help them make a decision about moving in and staff have enough information so they can understand and meet the persons needs. Evidence: There is a good system to introduce people to College Green with information provided and checks on peoples needs carried out so they know that their needs can be met at the home. People are invited to visit College Green before they move in so they can have a look around and meet the people who live there and staff. Because peoples opinions about the service are important to management, they (and their families) are given a quality questionnaire about their first impressions and their feedback is used to develop and improve the service Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans for the people who live at College Green are thorough so that their health and personal care needs were being met well by staff who respect their privacy and dignity. Evidence: The staff have worked hard with people who use the service, developing care plans that are unique to them so that they receive the right amount of support and care that meets their needs. There are systems in place for reviewing peoples care plans and managing risks to each individual, to ensure they stay as independent as possible while remaining safe. There was evidence in records that people have access to health services and a GP of their choice and that they receive treatment as they need it. Staff who we spoke with during our visit were able to discuss in depth the needs of the people whose care we tracked and their preferences about how their care should be given. During our visit we observed how staff respond to people when they ask for assistance and this was done respectfully and without delay. We saw in care plans that staff had obtained a lot of information about the social, cultural and leisure needs of people living in College Green. This means that staff have Care Homes for Older People Page 12 of 25 Evidence: the information they need to make sure each persons support and lifestyle meets their needs. To guide staff who give out peoples medication, there is a written procedure about this and records show they receive training and regular updates to ensure they have the competence to do this safely. We looked at how peoples medication is stored, how prescriptions are obtained and the records that staff fill in as medication is given. We found the system to be satisfactory and there was an audit trail of drugs received into the home and returns of unwanted medication to the pharmacy. This means that all medication accepted into the home is accounted for. Everyone who lives in College Green has a single bedroom, some having en suite facilities. There are good systems for returning peoples clothing after laundering and clothing was in good condition. Care plans and records are secured when not in use to make sure they are private and confidentiality is respected. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed so they provide daily variation and interest for people living in the home. Evidence: We did not meet any visitors during our time in College Green but records we saw showed that people who live there have regular visits from family and friends and the manager confirmed there are no unreasonable restrictions on visiting times. An entertainer visits College Green once a month and a garden party at the home was planned for the week after our visit. The manager said that residents family and friends would be invited. Staff said they escort people out into the local area from time to time as there is a park and some shops nearby. People were moving freely into the garden as the weather was fine at the time of our visit and a member of staff was involving them in a game of bowls. The manager told us that the activities of the day vary and depend on what people would like to do. We saw that staff spend a lot of time talking with people who live in the home and have developed good skills to communicate with them. People appeared to be at ease with staff and were offered choices about what they wanted to do that day. When we read care files we found that information is kept about peoples spiritual Care Homes for Older People Page 14 of 25 Evidence: needs and arrangements made for ministers of local churches to visit College Green to offer communion or hold a service, in accordance the needs and preferences of people living there. People who commented said the food is good and they get a good breakfast and plenty of drinks during the day. Records are kept of peoples monthly weights and these are monitored. The manager said that concerns about any persons weight would be referred to their GP and a dietician if necessary. We visited the kitchen and spoke with the cook. Catering records, including those of the food served for each meal, were available and in good order. There is a four weekly rotating menu which is seasonally reviewed. The cook confirmed that special diets such as low fat and low sugar are catered for according to the needs of people living in the home. We visited the food stores and there were good food stocks of fresh, dry and frozen foods there. Food is served in a dining area off the main lounge which provides a pleasant and congenial area in which to eat and has enough place settings for all the people who live at College Green. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good safeguarding procedures help to ensure that people remain safe in this home. The complaints procedure is clear and accessible meaning that people who use the service and their representatives feel listened to and taken seriously. Evidence: It was evident that peoples concerns are taken seriously as there is a complaints procedure in College Green which is given to people and is displayed. This is easy for people to follow if they want to make a complaint. We have not received any complaints about this service since our last visit there. We looked at records about procedures for protecting people who live in College Green. These showed us that guidance for staff is clear and their training in safeguarding procedures is up to date. Staff who were spoken with during the visit were clear about their responsibilities in protecting people and knew about how to report suspected abuse. There are clear and documented procedures for monitoring and reviewing peoples care to help ensure they will not be neglected and they will receive all the support they need in College Green. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. College Green is well maintained so that people who live there live in clean, pleasant and comfortable surroundings that are suitable for their needs. Evidence: During our visit we walked around the home to check the standard of accommodation for people who live there. People have single bedrooms which have pleasant views of the garden or the park. There is a passenger lift to bedrooms on the upper floors. We looked at all the bedrooms, which are highly personalised and in good decorative order. The communal space, a single lounge with dining area, is comfortable with enough seating for the people living at the home and good access to the garden through French doors via a ramp. The garden is secluded with a grassed area, shrubs and trees. There are assisted bathrooms and toilets throughout the building. The utility areas are in the basement and provide storage, a laundry, kitchen, and a medication store. There is off street parking at the front of the building. People told us they liked their bedrooms and their home is comfortable. Domestic staff are employed in College Green and they have received training in infection control and control of substances hazardous to health. Staff said there is always plenty of protective gloves and aprons available to help avoid the spread of infection. On visiting the locked area where cleaning materials are stored, we found there to be plenty of cleaning agents in stock. The building was very clean and odour free during our visit. There is a good system in the laundry to avoid contact between Care Homes for Older People Page 17 of 25 Evidence: laundered items and those to be washed, which helps avoid the risk of cross contamination. A person living in College Green said that staff work hard to keep the place nice. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Thorough staff recruitment procedures are used and there is a good programme of staff training to make sure that the people who live at College Green receive good quality care from staff who are suitable to work with them. Evidence: We looked at the details on the staff roster for the day of the visit and it was a true representation of the people on duty and their job roles. We saw that a roster is consistently maintained in College Green, and this shows the numbers of staff on duty every day to support the people living there and keep the home in good condition. The manager said that there is one care vacancy for weekends which was being covered by current staff because a person had been appointed and was awaiting criminal records bureau clearance. Records show that there is ongoing training for staff in mandatory courses and most staff have National Vocational Qualifications (NVQ) in care and have done a course in dementia care. This means that staff have the skills and qualifications to support people and understand their needs. There is a low staff turnover in College Green, most staff have worked for several years in this home, meaning there is good continuity in care giving. There is a robust recruitment procedure followed in College Green and we saw Care Homes for Older People Page 19 of 25 Evidence: evidence of this in two staff files. We saw records to show that staff had been interviewed and vetted before taking up their post. There was evidence of their induction training when first employed and of the ongoing training they have received during their employment. Good vetting and training helps to make sure that only those who are suitable to work with people who have dementia will be employed in the home. Staff have job descriptions and contracts of employment and said they receive good support from the manager and they enjoy working in College Green. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. College Green is well managed so it is run in the best interests of the people who live there and their opinions are taken seriously and used to improve the service . Evidence: The manager is registered with the commission and has worked in College Green for several years. She has a management qualification and a lot of experience in running care homes and supporting people who have dementia. She represents a very good role model for the staff working in the home and has good people skills. She has worked hard to make sure that the standard of care being provided is good, that record keeping is good and that staff are all aware of the policies and procedures for the home. She has set up reliable systems to support the efficient management of the home as all information we asked for during our visit was available and wellmaintained. The manager has good communication skills and always sends us notifications about matters we need to know about. She showed knowledge of the individual wishes and needs of the people who live in College Green because she Care Homes for Older People Page 21 of 25 Evidence: reviews their care plans every month and keeps updated records. She provides good leadership to make sure that the diverse and individual needs of the people who live in the home are met with respect and dignity. The ethos of College Green is open and transparent. A person who lives in the home said the manager is very kind and staff said they are well supported by her. In the managers absence, a deputy is employed to take over her responsibilities. We saw in records that people who live in the home and their families are consulted about the home every six months through the distribution of quality questionnaires. The responses are monitored and information received is used to develop and improve the service. This means that people have a say in the running of their home. The manager confirmed that the home has no involvement in peoples financial affairs and they are billed for the service they receive, which means their financial interests are protected and they know what they are being charged for. There was evidence in records that people who have no family to act on their behalf have access to independent advocates to help them if necessary. We looked at the certificates for safety checks on the building and equipment in use, and these were satisfactory. There were also good records for risk management regarding the building, personal safety and accident monitoring. For staff guidance there are clear procedures on safety and risk management, and the records show they receive relevant training (such as for patient handling) and updates. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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